ADSA: our dietitians don’t dish up advice to please Big Food

There is nothing new about links between dietitians’ associations and Big Food globally – or protestations from both sides that there are no conflicts of interest whatsoever. Independent research scientists and consumer activists worldwide beg to differ. They say Big Food benefits massively from being in bed with dietitians and their associations through ‘health by association’ and ‘health washing’ of its products. Dietitians who run associations supposedly devoted to improving people’s health, seem chronically unable to see the questionable ethics of accepting money from companies making products shown in research to contribute to global epidemics of obesity, heart disease, diabetes and cancer – and more recently dementia, which doctors are calling type 3 diabetes because of its link with bad diet.

In SA, the Association of Dietetics in SA (ADSA) has come under special fire for appearing to act as a proxy for Big Food by reporting one of the food industry’s biggest bêtes noires – University of Cape Town emeritus professor Tim Noakes – to the Health Professions Council of SA for unprofessional conduct. That was for a single tweet in which he said that the best weaning foods for infants are low-carb, high-fat (LCHF) foods, in other words, meat and veg. It’s a message that leaves a very bad taste in the mouths of many food makers. Here, ADSA executive member Maryke Gallagher responds to a blog in BizNews by Cape Town food consumer activist Sonia Mountford criticising the association’s close links with the food industry. – Marika Sboros

I would like to address some of the concerns and provide a more balanced view on the issues raised:

Ms Mountford’s arguments are not new, and she quotes several international studies to justify her arguments but references no credible empirical research locally that finds an “unhealthy”, compromising and complicit relationship between big foods and dietitians, which she claims.

ADSA is not the only body that raises funds from the sector in which it operates. It’s a common practice, and there is nothing sinister about it. That is exactly why ADSA is open and transparent about who our sponsors are and our sponsorship policy is readily available on ADSA’s website.

Maryke Gallagher

Sponsors should never be allowed to dictate an organisation’s messaging and content, especially in the health sector where all information should be evidence-based and “first do no harm”. We firmly believe that, as health professionals, we follow this mantra and that our members have sufficient training to be able to assess evidence-based, peer-reviewed literature and are aware of possible undue influence.

The independence of ADSA is not compromised by the support it receives from the food industry. While, in a perfect world, professional associations should be completely independently funded, we, like many other associations, don’t have the resources or benefactors to support the work we do to promote the profession and provide ongoing professional training to members.

We are proud that we raise 66% of our funds from members’ fees, but this is insufficient to sustain the organisation. Only 34% of our funds are raised from sponsors, with their full understanding of our sponsorship policy.

Many of our sponsors are retail competitors which in itself mediates unfair advantage of one product or company over another. The most we get from any one sponsor annually is about R60 000.

Code of conduct

Ms Mounford’s concern creates the impression that we are cash flush and powerful enough to dictate a nation’s diet. Far from it. An operating budget of less than R500 000 annually to serve roughly 1 350 dietitians nationally is hardly the resources required to conduct the work we do, let alone indulge in the antics we’re accused of.

Dietitians themselves have a code of conduct that specifies that they are committed to providing systematically assembled, evidence-based advice after careful assessment and diagnosis based on the individuals nutritional and health status, and must take the necessary steps to avoid bias and commercial interests.

ADSA does not recommend or endorse brands, products or services. Our donors are not permitted to publicise their support nor use our logo on their websites or on their products. Anyone who has recently consulted a dietitian would know that, rather than promoting a brand or products, dietitians advise patients to read the labels of products and consume foods that address their particular health needs, whether it’s no sugar, low fat, low salt, high fibre or reduced carbohydrates, for example.

Marketing hype

Dietitians are trained as experts in nutrition and that training includes being able to interpret scientific evidence and separate fact from marketing hype. Ultimately, we educate our patients by providing sufficient information to empower them to make informed food and purchasing choices. Patients can choose to shop at large retailers, eat organic foods or support local farmers markets. It’s their choice.

ADSA does contribute to related draft legislation, as do many NGOs, industry bodies and even members of the public. This is not unusual and ADSA does not unfairly influence legislation in the interest of big foods. ADSA has often submitted comments that might be considered unpopular by some food companies.

We comment on legislation to benefit the health of all South Africans based on current best practice. To craft legislation in the absence of such evidence would be ill advised. Ultimatley Government drafts regulations based on its own policy considerations which, at present, is guided by the fight against Non Communicable Diseases (NCD’s) such as hypertension and obesity.

ADSA strongly supports the policy of reducing such NCD’s through diet.

Finally, South African consumers can take comfort that the local food industry is highly regulated. Food labelling regulations, for example, include permitted and/or prohibited nutrition and health claims, endorsement and the presence and levels of additives.